It has become a tradition here at Ambra Health that our team makes predictions for healthcare trends at the end of every year. Just a few years ago, the cloud was still treated with suspicion in healthcare and now has moved to be a key way that health systems solve complex workflow challenges and extend medical imaging access. It also wasn’t long ago that we predicted how AI and machine learning would be the talk of the town only to now see them in use and offering real actionable insights for improved patient care. As our world becomes more global and more millennials become the decision makers in the workplace, healthcare may be placed with a new set of demands to increase data access, availability, and promise secure recovery.
Here are 10 trends to watch for in 2019:
Interoperability within large healthcare systems has slowly and steadily improved over the years. Medical practices and outpatient imaging centers associated with a large hospital system often merge data in a singular patient portal much to the appreciation of patients. For example, at Johns Hopkins, the IT team has put all the new community hospitals within their network on the same system. Many members of their oncology team travel to different hospitals to see patients, and they now can view imaging that has been done at the main hospital from any site. However, there are few of us that stay within the lines of one healthcare system throughout our lifetimes, especially millennials who make up over 42% of movers. How will facilities keep track of data across city and state lines and reduce duplicative labs and imaging tests? We’ve already seen several emerging efforts for enhanced interoperability. This fall, the CommonWell Health Alliance, announced the general availability of the CareQuality Connection. The connection will allow CommonWell and Carequality-enabled healthcare providers, through some of the industry’s largest participating EHR vendors, to connect and bilaterally exchange health data to improve care coordination and delivery.
The one-year countdown is about to begin. On January 1, 2010, PAMA (the protecting access to medicare act) will require physicians to review appropriate use criteria before ordering any advanced imaging services like CT or MRI for Medicare patients. The goal of the initiative is to reduce unnecessary exams and lower healthcare costs. Additionally, physicians can also share the criteria with patients to explain why an exam may or may not be necessary. Many physicians feel that EHR data entry already takes up a large portion of their time and fear this additional step in their daily workflow. However, others are already seeking new methods of automation. Companies like Cranberry Peak are using AI algorithms to act as a digital assistant to physicians when reviewing appropriate use criteria.
New legislative requirements at the state level have been established with the goal of providing more pricing transparency to beneficiaries. At the national level, Medicare is working to create a public price transparency website to encourage consumer choice by providing accurate information around out of pocket costs. There have also been several efforts to steer patients to free-standing facilities over hospital imaging. A well-known case is that of Anthem, who denied CT and MRI coverage in hospital settings to patients that did not meet strict guidelines. As patients are increasingly focused on their own care, it’s important that programs market around certain preferences.
Did you know that 42% of cancer patients spend their entire life savings within two years of diagnosis? Data from a new study shows that medical costs from cancer are about $80 billion in the United States today. Dealing with a serious illness is an enormous emotional and financial burden on any family. It turns out that the financial burden is also a serious health consequence; patients who were forced to declare bankruptcy had a 79% greater risk of death than those who did not. Physicians should consider opening up the dialogue with patients when discussing costs and treatment options. Facilities can also offer financial counseling services to help families make the best decisions possible. And in the broader world of healthcare, initiatives like the 21st Century Cures Act seeks to unify enormous amounts of healthcare data, including data from clinical trials, so that patients may be able to find new and potentially more cost-effective treatment plans.
Researchers at leading facilities are seeking new ways to turn data into insights by easily de-identifying patient medical imaging data for use in research studies. Once imaging is freed from silos, its potential for research, AI initiatives, and machine learning expands indefinitely. Leading academic facilities are determining new guidelines such as adding explicit language to patient forms, keeping data for internal research projects only, and establishing healthcare research clouds for academic research projects and multi-site trials. Dr. Gregory Moore, Vice President of Healthcare at Google Cloud, was recently quoted in Healthcare IT News, stating that, “Unlocking the value of complex, disparate healthcare data sources is a significant challenge for many organizations We believe that cloud-based technologies offer a significant advancement for the management and understanding of data.”
Most millennials are no longer fresh-faced college students; they are approaching their thirties, acting as the decision makers in their roles, purchasing homes, having children, and being the advocates in their own healthcare trajectories. Millennials have high expectations in regards to ease of access to healthcare data, user-friendly patient portals, digital contact with physicians, and pricing transparency. Forward-thinking providers should be working to increase their digital presence by bolstering online reviews, enhancing their websites, and creating more comprehensive self-service patient experiences.
The millennial generation is the most diverse in American history, and they expect to see this diversity in the workplace, including at the leadership level. In radiology and informatics, women have traditionally represented a much smaller portion of the workforce. Today, the ACR Commission on Human Resources Workforce Survey states that only 21% of practicing radiologists in the United States are women, a percentage that has not changed significantly in the past several decades. RADxx, a movement designed to offer networking and mentorship opportunities to women in the field, has seen enormous growth over the past few years, with over 250 individuals attending the annual awards events in 2018. It’s not just in radiology – this past year brought forward a lot of discussion concerning how women often still face discrimination in the workplace and how parental leave policies still tend to more negatively impact women than men. Across healthcare as a whole, we expect to see a new push towards promoting stronger work-life balance for women, men, and families in 2019.
Teleradiology has the potential to bring top healthcare access globally to underserved communities. During the RSNA 2018 conference, RAD-AID shared some of the incredible stories from their efforts to bring radiology health services to communities during Google’s Corporate Symposium. RAD-AID is a nonprofit global health charity organization of 10,000 radiology volunteers and supporters, serving 53 hospitals in 27 countries to build radiology health services in low-resource communities via on-site educational training, equipment implementation, and technology development. RAD-AID worked together with Google Cloud and Ambra Health’s cloud PACS software to bring a digital radiology infrastructure to a rural children’s hospital in Laos. Imaging is sent to the Google Cloud for an archiving and a teleradiology workflow which allows the radiology team to provide comments on abnormal scans and flag scans that need additional review by an outside US-based volunteer radiologist.
As artificial intelligence and machine learning gain more traction in radiology, how can facilities be sure to appropriately evaluate new tools? How can one assess the efficacy and validity of a vendor’s application? One approach is to treat new applications like new hires, give them a test period, ask each individual who is impacted by them how it is going, and offer appropriate feedback when necessary. Workflows are key and even if the best tools are available to a physician, they will be of no use unless a change management process integrates new tools into the workflow.
Recent natural disasters have cost healthcare facilities in the United States over 200 billion dollars, a number that doesn’t appear to be slowing down. The effects of such disasters can be long-lasting and many facilities have begun taking a much more active role in seeking disaster recovery and business continuity plans. One popular method is a virtual approach, storing data in the cloud so that even if physical hardware is damaged, the data remains secure. Additionally, many facilities have considered telemedicine and teleradiology options so that patients in inaccessible areas may still have a method of contact. Facilities must take into account that any disaster recovery planning should be enterprise-wide as IT systems across facilities are often interconnected.